Employee Benefits

The companies that EVMS contracts with for employee benefits are adjusting their practices to help employees during the COVID-19 pandemic. In addition, federal guidelines are changing to assist employees.

The Family First Coronavirus Response Act (FFCRA or Act) requires certain employers to provide their employees with paid sick leave and expanded family and medical leave for specified reasons related to COVID-19. These provisions will apply from April 1, 2020 through December 31, 2020.

Last Updated 03-31-2020 5:57 p.m.

Generally, the Act provides that employees of covered employers are eligible for:

Two weeks (up to 80 hours) of paid sick leave at the employee’s regular rate of pay where the employee is unable to work because the employee is quarantined (pursuant to Federal, State, or local government order or advice of a health care provider), and/or experiencing COVID-19 symptoms and seeking a medical diagnosis; or

Two weeks (up to 80 hours) of paid sick leave at two-thirds the employee’s regular rate of pay because the employee is unable to work because of a bona fide need to care for an individual subject to quarantine (pursuant to Federal, State, or local government order or advice of a health care provider), or to care for a child (under 18 years of age) whose school or child care provider is closed or unavailable for reasons related to COVID-19, and/or the employee is experiencing a substantially similar condition as specified by the Secretary of Health and Human Services, in consultation with the Secretaries of the Treasury and Labor; and

Up to an additional 10 weeks of paid expanded family and medical leave at two-thirds the employee’s regular rate of pay where an employee, who has been employed for at least 30 calendar days, is unable to work due to a bona fide need for leave to care for a child whose school or child care provider is closed or unavailable for reasons related to COVID-19.

Certain employees are exempted from paid sick leave or expanded family and medical leave under the FFCRA. Please contact Human Resources to determine if you are eligible.

Congress has passed a stimulus package to offer some relief from the economic effects of coronavirus. The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) is designed to bring financial relief for individuals and families. Highlights include:

Optima Pharmacy Benefits

As part Optima Health's ongoing commitment to members as we navigate through the novel coronavirus (COVID-19), we are making it easier for members to obtain their needed prescriptions.

Optima Health is implementing pharmacy benefits changes to help make sure members have access to their necessary prescription medications while limiting the possibility of COVID-19 exposure.

EARLY REFILLS

Optima Health has made the following changes to make sure members have an appropriate amount of medication on-hand:

We will allow for early refills, if needed. If members need extra medication, they can talk to their pharmacy about filling their prescription early. Members will be responsible for their standard cost share.

For the safety of our members, members or their pharmacy will need to call for an override to refill an opioid prescription early.

90-DAY REFILLS

Optima Health allows members to fill 90-day supplies of medication at most retail pharmacies and by mail order.

We have implemented a one-time 90-day fill of specialty medications. Members will be responsible for their standard cost share.

We encourage the use of 90-day supplies for medications members take regularly.

If members don’t have a prescription for a 90-day supply, they can talk to their physician to see if a 90-day supply would work for them.

HOME DELIVERY OPTION

Our mail order pharmacy can deliver a 90-day supply of medications to members’ homes.

For more information on COVID-19, please visit the Centers for Disease Control and Prevention website at www.cdc.gov. You may also visit optimahealth.com/coronavirus for more information and additional updates.